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General NPI Number Information
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NPI Number | 1972961118
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Entity Type | Organization
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Legal Business Name | BERNARDITA N LIZAN DMD,INC
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 550 E 8TH ST STE 12
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2355
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Country | US
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Telephone | 619-477-7570
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Fax |
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Provider Business Mailing Address
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Address Line | 550 E 8TH ST STE 12
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2355
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Country | US
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Telephone | 619-477-7570
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BERNARDITA N LIZAN
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Credential | DMD
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Telephone | 619-477-7570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 37131
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License Number State | CA
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